Ana Collazo Lorduy, Department of Oncology, Hospital Puerta de Hierro, Madrid – Clarify Team

Fear has been the overriding emotion felt by cancer survivors since the Covid-19 pandemic began: Fear of contracting the disease, fear of not having respirators or intensive care units (ICU) available, fear of going to the hospital, fear of not being able to see their specialist.

The consequences of the coronavirus pandemic have impacted all of us as a society over the last year, but even more so on cancer patients and those who, even with the disease in remission, felt their lives to be limited and their future uncertain.

On top of this has come the collapse of overloaded hospitals. According to data from the European Society of Oncology (ESMO), this has led to around 20% fewer cases of cancer being diagnosed in Europe during this period. This is also reflected in the recently presented European Cancer Plan “Moreover, the COVID-19 pandemic has severely impacted cancer care, disrupting prevention and treatment, delaying diagnosis and vaccination, and affecting access to medicines. Since the pandemic began, the number of cancer diagnoses has decreased, foreshadowing a future increase in cases.” In some severely overloaded hospitals, there has also been a delay in follow-up and administration of treatments for chronic disease in these patients.

In addition, it is important to note that, to date, there are no clear protocols for follow-up and action in long-term cancer survivors, meaning they have to be included in action protocols for the general population even though they are clearly potentially more susceptible to COVID-19 and its complications.

At the patient’s side

What have we as professionals tried to do to limit the social isolation and psychological impact of this pandemic on cancer patients, who already have specific emotional needs?

Medical Oncology services have struggled to continue to administer treatments on more spaced-out schedules to limit visits to the hospital. Telephone consultations have also been implemented, paving the way for telemedicine when possible; patients have been able to contact oncologists and feel someone is there for them. This has, therefore, offered a good opportunity to change and expand the ways we communicate with patients and minimize the risks of attending hospital in person. Necessitated by the context, remote medical care can lead to innovation in healthcare resources that will hopefully continue beyond the pandemic.

Lastly, it is worth highlighting the importance of clinicians’ communications with patients regarding their level of risk, as well as informing them when they should get in contact and that it is normal for them to have high levels of anxiety. Creating online patient support groups can be a very useful approach. Also, encouraging the physical exercise so essential for self-care and physical and mental wellbeing.

In summary, now more than ever during this crisis, cancer survivors need personalized attention, support and tools to help dispel the fear that has marked their lives over this last year of the pandemic.